Special care teams help U.S. patients, hospitals

CHICAGO (Reuters) – A new medical specialty that focuses on relieving pain and meeting the needs of seriously ill patients and their families could wind up saving the average community hospital in the United States as much as $1.3 million per year, researchers said on Monday.

They said special palliative care teams — often comprised of a doctor, nurse and social worker — can help hospitals reduce costs from unwanted tests or prolonged intensive care stays by helping patients and their families make informed decisions and get the resources they need.

“Palliative care teams take the sickest and most complex patients who are often at a loss in a fragmented health care system,” said Dr. Sean Morrison, who directs the National Palliative Care Research Center at Mount Sinai School of Medicine in New York.

“The health care system is set up to meet the needs of the average person. The person with a complex or life-threatening illness is not the average person,” said Morrison, whose study appears in the journal Archives of Internal Medicine.

“What these teams do really well is sitting down with patients and families and finding out what their individual goals are. They help patients and families select treatments,” Morrison said in a telephone interview.

Such teams focus on the sickest 5 to 10 percent of hospital patients with the most complex cases. Since many of these patients are also covered by Medicare, the federal health insurance program for the elderly, hospitals often lose money on them because they are only paid a set fee per admission.

Palliative care teams can help families find home health services in their community, make hospice arrangements, provide emotional or religious counseling and even advise patients how to deliver bad news.

“Often patients may want to go home, but because of their very complex needs, nobody knows how to bring together a fragmented health care system in the community to meet those needs,” Morrison said.

The researchers looked at patient records of nearly 3,000 palliative care patients who were discharged alive, and another 2,600 who died at eight different hospitals served by palliative care teams. Their cases were matched to similar patients who got typical care.

What they found is that hospitals with palliative care programs saved $279 to $374 per day, or $1,700 to $4,900 per admission of a palliative care patient.

That translated into savings of $1.3 million a year for a 300-bed community hospital, Morrison said.

“They streamline care so it really is patient-centered care,” he said. “In the process of doing that, they can reduce costs or are cost-neutral for most hospitals.”

Hospital palliative care programs started about a decade ago and have grown rapidly. In 2006, more than 41 percent of U.S. hospitals offered such a program.

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